What Is Known About COVID-19 and MIS-C, MIS-A & Long-haulers?

Dr. Paul Offit explains multisystem inflammatory syndrome in children and adults as well as long-hauler effects of COVID-19 infections.


What is known about COVID-19 and MIS-C, MIS-A & long-haulers?

Paul Offit, MD: Hi, I am Paul Offit. I'm talking to you today from the Vaccine Education Center at the Children's Hospital of Philadelphia. It's Wednesday, May 12th, 2021. I think one thing that's been interesting about this virus is it really wasn't what it was billed to be. When this virus swept through China and then left China, what we heard — what people in Europe heard, what people in Southeast Asia heard, what people in the United States heard — was that this was a winter respiratory virus like influenza. And like influenza, it could cause severe infection of the lungs and even fatal infection of the lungs. That's what this was supposed to be — a winter respiratory virus. But it is far more than that.

What this virus does that I think no one had anticipated is it causes you to make an immune response against your own blood vessels. It's unclear what the mechanism is by which it does that, but it does that. And it causes these sort of so-called multisystem inflammatory disease in children, which has the name MIS-C. It also causes a multisystem inflammatory disease in adults, which is now just being recently described, but certainly is far more common I think than what we've described now, which I think is just the tip of the iceberg, and that's called MIS-A.

Because every organ of your body has a blood supply, every organ can be affected. And that's what we're seeing in our hospital and pediatric and adult hospitals across the country, where people come in usually about a month or so after surviving the infection, and often it was just initially a trivial infection, either an asymptomatic or mildly symptomatic infection. And they come back a month later; they're not shedding virus anymore; they're PCR negative; they do have antibodies now in their bloodstream, but what they present with is high fever and involvement of the heart, liver, lungs or kidneys. And I have no doubt that like another disease called Kawasaki disease, which is another multisystem inflammatory disease that looks a lot like this, that many of these children and adults or at least a subset of these children and adults will go on to develop I think more long-term problems. I think we're seeing that in the term long-haulers. So, this is not influenza, which doesn't do this. This is a different kind of virus.

And I think that's why it's even all the more important to make sure that you get vaccinated so that you don't have to suffer these potentially longer-term problems.

Thank you.

Related Centers and Programs: Vaccine Education Center

Last Reviewed on Jun 01, 2021